Diagnosis and initial management of nonmalignant diseases related to asbestos

Our plain-English summary of Diagnosis and initial management of nonmalignant diseases related to asbestos, by A.J. Ghio, V.L. Roggli (American Journal of Respiratory and Critical Care Medicine, 2005).

The study

• Authors: A.J. Ghio, V.L. Roggli
• Journal: American Journal of Respiratory and Critical Care Medicine
• Published: 2005;171(5):527; author reply 528-30
• Type of article: Letter, Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item is a letter to the editor, printed with a reply from the committee whose work it criticized. It contains no new data. The letter's authors, Ghio and Roggli, responded to a 2004 American Thoracic Society statement on diagnosing nonmalignant asbestos-related diseases. They argued that the statement did not recognize that cigarette smoking can confound the chest X-ray diagnosis of asbestosis. Citing other researchers' work, they wrote four things. Small irregular opacities appear on chest X-rays in a significant number of people with no prior exposure to particles or fibers. Smoking can produce such opacities. Pathologic data link smoking to lung fibrosis. And a shared free-radical mechanism of fibrosis has been proposed for smoke and asbestos. The authors concluded that disregarding this evidence discredits the Society as a scientific body. In reply, the committee said the statement addressed this issue. It said even relatively heavy smoking changes the profusion of small opacities by at most one minor category. Because the criteria require nontrivial asbestos exposure and exclusion of other diagnoses, the committee said misdiagnosis is unlikely in practice.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: letter to the editor (correspondence) with a reply from the statement committee; no original data
• Who was studied: no study population; the letter responds to the 2004 American Thoracic Society statement on nonmalignant asbestos-related diseases
• Exposure: cigarette smoking as a possible confounder in the diagnosis of asbestosis
• Main results:
  • The letter stated (citing other work) that small irregular opacities appear on chest X-rays in a significant number of people with no prior exposure to particles or fibers
  • The letter stated (citing other work) that cigarette smoking can produce a profusion of irregular opacities
  • The letter stated (citing other work) that pathologic data link cigarette smoking to collagen deposition and fibrosis in the lung
  • The letter noted that free radical production has been proposed as a common route to fibrosis from cigarette smoke or asbestos
  • The committee replied that even relatively heavy smoking changes the profusion of small opacities by at most one minor category
  • The committee replied that, given the criteria requiring nontrivial asbestos exposure and exclusion of alternative diagnoses, misdiagnosis is unlikely in practice
• The authors' conclusion: Ghio and Roggli concluded that disregarding the evidence on smoking discredits the American Thoracic Society as a scientific body

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Related studies

• Diagnosis and initial management of nonmalignant diseases related to asbestos — D.D. Smith (2005)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — American Thoracic Society (2004)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — D. Weill, H. Weill (2005)
• Dose-response associations of silica with nonmalignant respiratory disease and lung cancer mortality in the diatomaceous earth industry — H. Checkoway, N.J. Heyer, et al. (1997)
• Re: "Dose-response associations of silica with nonmalignant respiratory disease and lung cancer mortality in the diatomaceous earth industry" — G.W. Gibbs (1998)
• Re: "Dose-response associations of silica with nonmalignant respiratory disease and lung cancer mortality in the diatomaceous earth industry" — M.J. Mirliss (1998)

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